Roman criteria for the diagnosis of irritable bowel syndrome (IBS)
The Roman Criteria are a set of guidelines that health professionals use to identify and classify symptoms of irritable bowel syndrome. These criteria are updated regularly by experts in the field and are named after the international meetings in Rome where they were developed.
They usually include specific criteria based on the symptoms that must be met in order to make a diagnosis of IBS. These symptoms are used to distinguish irritable bowel syndrome from other gastrointestinal disorders. Criteria may include:
- Abdominal pain or discomfort: presence of recurrent abdominal pain or discomfort on at least three days per month in the last three months.
- Bowel-related symptoms: Abdominal pain or discomfort is associated with a change in bowel habits, such as frequency or consistency of stools.
- Change in bowel habits: A change in bowel habits may include diarrhoea, constipation, or a mixture of both, often referred to as mixed or alternating bowel habits.
- Duration of symptoms: symptoms have been present for at least six months before diagnosis.
Note: The Roman Criteria are not intended to be used as a definitive diagnostic tool in themselves. Healthcare providers use these criteria as part of a comprehensive assessment that includes a medical history, physical examination, and possibly other tests to rule out other diseases.
What are the most common possible causes of irritable bowel syndrome (IBS)?
- Imbalance of the gut microbiome
- Visceral hypersensitivity
- Psychological factors (Disorders of the gut-brain axis)
- Abnormal intestinal motility
- Eating disorders
- Conditions following infectious poisonings that trigger a gut-brain axis reaction.
What is the gut-brain axis?
The gut-brain axis refers to the two-way communication between the gut and the brain. This communication takes place through various pathways, including the nervous system, hormones and the immune system. The gut-brain axis plays a key role in the regulation of many bodily functions, including digestion, mood, appetite and stress response.
When you experience stress or anxiety, for example, it can affect your gut, leading to symptoms such as digestive pain or changes in bowel habits. Similarly, problems in the gut, such as inflammation or an imbalance of gut bacteria, can send signals to the brain, impacting mood and cognitive function, creating a “vicious cycle” from which a person cannot escape.
Understanding the connection between the gut and the brain is crucial to overall health, as disruption of this communication pathway can contribute to various health problems, including irritable bowel syndrome (IBS), depression and anxiety.
Types of irritable bowel syndrome:
- Irritable bowel syndrome with constipation (IBS-C): the main symptoms are constipation, abdominal discomfort and abdominal bloating.
- Irritable bowel syndrome with diarrhoea (IBS-D): the main symptoms are diarrhoea, urgency and abdominal discomfort.
- Mixed irritable bowel syndrome (IBS-M): Alternating or mixed symptoms of both constipation and diarrhoea.
- Unclassified irritable bowel syndrome (IBS-U): Symptoms do not fall into any of the above categories.
Difficulties in diagnosis:
Diagnosing irritable bowel syndrome (IBS) is challenging due to the variability of symptoms between individuals, the lack of specific diagnostic tests, overlapping symptoms with other gastrointestinal disorders such as inflammatory bowel disease and functional dyspepsia, and possible misinterpretation of symptoms by patients and healthcare providers, the influence of psychological factors on symptom perception, the subjective nature of diagnostic criteria such as the Rome criteria, the potential stigma associated with gastrointestinal symptoms that leads to avoidance of seeking medical care or downplaying of symptoms, and misconceptions about IBS that delay accurate diagnosis and treatment.
These complexities highlight the importance of careful assessment by healthcare providers to ensure accurate diagnosis and appropriate treatment of irritable bowel syndrome.
Do you suspect symptoms of irritable bowel syndrome?
If, after reading this article, you suspect that you are suffering from this functional disorder, we recommend that you see a doctor immediately. To boost your preparedness and understand the possible triggers for your worrying symptoms, use this handy resource: a free online diary (thoughtfully created by the team at a Czech charity). You can download the app at HappyGut. This tool is designed to help you track your symptoms and provide valuable information about your health. The data is stored only locally on the user's device and is not transferred anywhere. Users can filter and organize this data by date and specific parameters, making it easy to create PDF files for subsequent discussion with medical professionals or personal viewing.
On your journey to optimal health, be sure to prioritize the care and treatment of your digestive tract. Be healthy!
Your Enterosgel-team :)